Wednesday 7 February 2018
Dementia Australia has welcomed the release of new guidelines to reduce unnecessary prescription of medications in older Australians living with dementia.
Dementia Australia CEO Ms Maree McCabe said Dementia Australia supports the National Health and Medical Research Council (NHMRC) approved guidelines that assist healthcare professionals determine when it might be suitable to trial the withdrawal of medications when treating people living with dementia.
“As an advocate for the 425,000 Australians and their families impacted by dementia, Dementia Australia is encouraged by the release of guidelines that recognise that the experience of people living with dementia is individual and unique,” Ms McCabe said.
“While there are certainly instances where the prescription of ongoing and multiple medications is beneficial for people living with dementia, this is not always the case. Over time, certain medications can lose their effectiveness and they can hinder quality of life rather than improve it.
“As for any change in treatment and as recommended in the guidelines, the withdrawal of medication should be a discussion between the healthcare professional, the individual and their carer to ensure the individual and carer are informed of the potential harm and benefits of continuing or discontinuing use. Good communication is critical.”
Centre for Medicine Use and Safety Professor Simon Bell said that there was increasing evidence about the value of proactively discontinuing medicines for which the potential benefits no longer outweigh the potential risks.
“The guideline provides clinicians, consumers and carers with new recommendations regarding the withdrawal of cholinesterase inhibitors or memantine. In particular, the guideline highlights the important role of people with dementia and their carers in deciding whether or not to trial discontinuation,” he said.
Former carer, Ms Tara Quirke, who is also an advisor on the guidelines and advocate for the consumer voice in treatment decision making, said from a care partner perspective, these guidelines are timely and provide strong evidence of the need to reduce medications that are no longer effective, or may cause more harm, to the person living with dementia.
“These guidelines put individuals’ values, preferences and experiences ahead of their illness. I am encouraged by the very clear message it sends to everyone who is treating, caring for or living with dementia,” Ms McCabe said.
“What’s important now is that these guidelines are read and considered by all clinicians.”
Cholinesterase inhibitors (such as donepezil, rivastigmine or galantamine) and memantine may be prescribed to individuals to offer some relief from the symptoms of Alzheimer’s disease. The use of these medications is increasing, with approximately 20,000 people prescribed cholinesterase inhibitors yearly.
The development of the guideline is part of a project funded through the NHMRC Cognitive Decline Partnership Centre (CDPC), to help determine how to manage medicines in people with dementia better in the future. The guideline was developed by The University of Sydney, in conjunction with the Bruyère Research Institute (Canada), and can be accessed from: http://sydney.edu.au/medicine/cdpc/resources/deprescribing-guidelines.php
Dementia Australia is the national peak body and charity for people, of all ages, living with all forms of dementia, their families and carers. It provides advocacy, support services, education and information. An estimated 436,000 people have dementia in Australia. This number is projected to reach almost 1.1 million by 2058. Dementia Australia is the new voice of Alzheimer’s Australia. Dementia Australia’s services are supported by the Australian Government.
National Dementia Helpline 1800 100 500
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